Survival analysis of patients with duodenal gastrointestinal stromal tumors.

GOALS: To evaluate the survival characteristics of patients with duodenal gastrointestinal stromal tumors (GISTs).

BACKGROUND: GISTs represent the most common mesenchymal neoplasms. However, duodenal GISTs are relatively rare, and few studies have been performed with a focus on duodenal GISTs.

STUDY: We collected the data of 41 GIST patients including 7 duodenal cases. Clinicopathologic findings and recurrence-free survival (RFS) of duodenal GIST patients were analyzed.

RESULTS: The proportion of having any symptoms was 86% in duodenum, 32% in stomach, and 56% in other GISTs (P=0.034), and the most common symptoms of duodenal GISTs were melena and anemia. The 2-year RFS rates were 51.4% in duodenal GISTs, 78.4% in stomach GISTs, and 100% in other GISTs, and duodenal GISTs showed poorer RFS than nonduodenal GISTs (hazard ratio, 5.1; log-rank P=0.019). Particularly, in low-risk and intermediate-risk group, the hazard ratio of recurrence was 12.3 (log-rank P=0.010). Multivariate Cox analysis showed symptom (P=0.007), mitotic index (P=0.011), and tumor location (P=0.043) were significant prognostic factors of recurrence.

CONCLUSIONS: RFS of duodenal GISTs was worse than nonduodenal GISTs.